Features of General Reactive Potential of the Body in Infants with BCG lymphadenitis
Objective: integrated health assessment of infants with BCG-induced regional lymphadenitis.
Material and Methods. The work was carried out on the academic basis of pediatric infectious departments of Donetsk region and Donetsk regional laboratory center of State sanitary and epidemiological service of Ukraine. Comparative analysis of complications of BCG vaccinations in the form of regional lymphadenitis for 3 years is carried out. Evaluation of immune status was based on a comprehensive study of indicators of general reactive potential of the organism by studying the qualitative-quantitative characteristics of hemogram.
Results. In Donetsk region for 3 years 19,078 children were vaccinated with BCG vaccine (Denmark) and 14,328 — with BCG vaccine (Russia), of whom 210 children developed complications: 143 (0.74 %) children were vaccinated with BCG vaccine (Denmark) and 67 (0.46 %) — with Russian BCG vaccine. Clinical forms of complications to some extent were determined by the nature of the BCG vaccine. When using the BCG vaccine (Denmark), infiltrative forms were 2.2 times more common among the complications in the form of lymphadenitis of various localization, and the presence of a fistula (5.7 %) were detected compared with children vaccinated with BCG vaccine (Russia). In addition, very rare complications were 3 times more frequent — 10 versus 3.3 %. They are: plague is the middle third of the left shoulder; sternoclavicular combination of BCG assoc., dest.+ MBT(–), newly diagnosed tuberculosis (NDT), secondary pulmonary tuberculosis; tuberculous osteitis of the right hip; tuberculous osteitis of the lower third of the right hip; tuberculous osteitis of the 4/3 of the right femur; tuberculous osteitis of the left knee joint with BCG vaccine (Denmark). When BCG vaccine (Russia) was used, we detected only NDT, tuberculous osteitis and NDT, onitis, D+, MBT(+).
Features of general reactive potential of the organism at BCG vaccination are determined by more significant degree of inflammatory activity in young children, as well as by a decrease in the body’s ability to respond to antigenic stimulus and a pronounced risk of breaking a barrier to infection — the possibility of generalization of infection in infants on the background of normal allergic disposition of the body.
Conclusions. When using BCG vaccine of Russian production, there is far less significant overload of blood flow by products of intoxication and inflammation, more pronounced body’s ability to respond to antigenic stimulus generalization and no risk of infection, especially in infants, compared with Danish BCG vaccine. For vaccination of infants against tuberculosis, it is advisable to use more refined, with high immunogenicity and less reactogenic BCG vaccine of Russian production. Despite the presence of complications when using BCG vaccine, protection of the body from the development of generalized forms of tuberculosis in young children is possible by vaccination in the neonatal period.
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